Board Affiliate blog – Kavan Nagi – August 2025
Reflections of a Board Affiliate at Buckinghamshire Healthcare NHS Trust (BHT)
A year ago, I began my role as a Board Affiliate at BHT, eager to listen, learn, and contribute. It’s been a defining experience in my leadership journey, offering deep insight into NHS governance, strategy, and the people behind it. I’ve observed, contributed, and grown within a leadership environment that balances complexity with compassion.
A seat at the table and understanding Board-level leadership
This role gave me something few emerging leaders experience; a seat at the table where strategic decisions affecting thousands of patients and staff are made.
As a Board Affiliate, I actively participated in committee and Board meetings without voting rights, and was encouraged to ask questions, challenge assumptions, and share my views. The role offers emerging leaders valuable exposure to board-level decision-making, with the opportunity to engage across the full breadth of Board business, including that which is delegated to:
- Strategic People Committee – covering workforce strategy, staff experience, and leadership development.
- Finance and Business Performance Committee – covering financial sustainability and delivery of key operational targets.
- Audit Committee – providing assurance on risk, compliance, and governance processes.
- Quality Committee – overseeing clinical effectiveness, patient safety, and experience.
Each Committee reviews details and risks, providing focused advice and assurance that helps the Board make informed strategic decisions.
Personal highlights: Care Awards and “Go See” visits
Starting Board meetings with Care Awards was always a highlight, setting a positive tone and celebrating colleague contributions – an approach worth wider adoption across the Trust.
This year, “Go See” visits have been increasingly integrated into Committee and Board schedules. They foster direct connection with colleagues across clinical and non-clinical teams, providing insights beyond reports, grounding strategic discussions in real experience, and emphasising that excellent care depends on every team and function.
What I’ve learned so far
Although the Trust Board could seem distant, I saw a team of dedicated, skilled individuals grappling with complex challenges to make the best decisions for patients, staff, and the wider system.
I learned:
- How strategic governance functions under pressure and the importance of balancing risk, resources, and values.
- What compassionate leadership means to me: I’m grateful for the generosity of the Board members; their time, insight, and investment in me have shaped the leader I aspire to be.
- Silence in the boardroom doesn’t always mean agreement; often, the best input is a thoughtful challenge.
The experience has highlighted a challenge I’m still navigating, how I balance my passion for patient care with a growing interest in strategy.
The power of inclusion and looking ahead
At the start, the pressure of representing multiple minority groups, as a proud, disabled, BAME woman, was hard to shake. Over time, I learned to lean into subtlety, not my usual style! I found that building allies and making space for others is as powerful as speaking out. Ironically, the less I pushed the inclusion agenda, the more I was invited in. That shift has strengthened my confidence and evolving leadership style.
The Affiliate programme reflects BHT’s commitment to nurture future leaders. I’m grateful for the support and aim to deepen my impact in my remaining time. To anyone considering this role: don’t wait until you feel “ready.” If you’re curious, committed, and passionate about the NHS, you’ll gain far more than you expect.